Interferon therapy in chronic hepatitis C. Evaluation of a low dose maintenance schedule in responder patients

Evidence has accumulated that interferon therapy can be effective in reducing transaminase levels and improving liver histology in patients with chronic hepatitis C. Unfortunately, the relapse rate after discontinuing treatment remains a problem. In this study the efficacy of a low dose of interferon was investigated for preventing relapses in patients who completely responded to a 6-month course of 3 MU 3 times a week. Eighteen out of 30 patients (60%) had normal ALT at the end of the 6th month of therapy. These patients were randomly allocated to receive either 1 MU interferon 3 times a week for 6 months or no treatment. Three patients (33.3%) without maintenance schedule and 4 (44.4%) treated with 1 MU relapsed. HCV-RNA was positive in 23 tested patients at entry and became undetectable in patients with sustained response. Relapse was associated with RNA reappearance. A post-therapy liver biopsy, performed in 8 patients, showed Knodell's score improvement. In conclusion, our study confirms the efficacy of interferon at the dose of 3 MU 3 times a week for 6 months. A low maintenance dose of interferon seems to be ineffective in preventing relapse in patients with chronic HCV infection who have responded to a prior treatment course.